Search

In recent years, scholars have examined the barriers to accessing public assistance benefits. Research identifies learning, compliance, and psychological costs as deterring program use. Compliance costs reflect the burdens of following program rules, which may entail providing documentation, responding to discretionary demands of bureaucrats, or attending appointments to maintain benefits. Studies identify one element of compliance costs—quarterly appointments—as a barrier to continued WIC participation. This article draws on 44 in‐depth qualitative interviews with participants in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC). We examine how WIC participants perceive the reduction of compliance costs following the implementation of remote appointments in response to the COVID‐19 pandemic. WIC participants report satisfaction with remote appointments and a reduction in the compliance costs of accessing and maintaining benefits. We conclude by recommending longer term changes to policy and practices to increase access and continuity in WIC receipt.

Previous research shows that the way transfer income is disbursed can affect what households purchase with that income. In this paper, I provide evidence that disbursement technique can affect the timing of purchases as well. I examine the U.S. Supplemental Nutrition Assistance Program (SNAP), which switched on a state‐by‐state basis from cash‐similar food coupons to Electronic Benefit Transfer (EBT)—a secure debit card—from 1993 to 2004. I find that EBT mitigated boom and bust cycles in food spending associated with SNAP disbursement. This effect is entirely driven by households with children (about two thirds of the SNAP population), who experienced more severe cycles prior to EBT. The effect operates only through the intensive margin—the amount spent on food during a shopping trip—and not at all on the extensive margin—the likelihood of going food shopping.

School meals provide nourishment to a large portion of US schoolchildren. Research has examined the relationship between the consumption of school meals and the quality of schoolchildren's diets, with little emphasis on studying spillovers at the household level. Using National Food Acquisition and Purchase Survey data and unconditional quantile regression, we study the relationship between a household's quality of food‐at‐home acquisitions and the number of school meals acquired, subsampling households by their Supplemental Nutrition Assistance Program participation status. We do not find strong evidence supporting beneficial spillovers of school meals on a household's quality of food‐at‐home acquisitions. JEL CLASSIFICATION C31; D12; I14; Q18

Beginning in the 1990s, states have received unprecedented flexibility to determine Supplemental Nutrition Assistance Program (SNAP) eligibility and program administration. We find state SNAP policies accounted for nearly half of the 2000–2016 caseload increase. State economic conditions also play an important role in caseload changes, accounting for almost half of the 2007 through 2013 increase. Within distinct periods of our 1990–2016 data, policy and the economy make different contributions to caseload changes. Policy simulations indicate that mandating states to maintain their 2000 SNAP policies, prior to the greatest expansion in latitude, would have lowered 2000–2016 caseload growth by 38%.

Objective To describe the Healthy Meal Program (HMP), a community-academic partnership that aims to address the food insecurity and social isolation in older adults living in an urban setting. Program implementation Low-income older adults were screened for food insecurity and social isolation. A partnership with the food bank and a farm-based organization helped provide a weekly congregate or home-delivered meal, pilot a cooking class, and offer a mobile market selling fresh vegetables at discounted prices. Program evaluation Overall, 339 individuals agreed to participate in the screening process. Sixty-eight percent (n = 230) screened positive for food insecurity and 41% (n = 139) screened positive for social isolation. Among individuals who were food insecure, 159 were referred to a food commodity program, 31 to meals on wheels, 23 to Supplemental Nutrition Assistance Program benefits, and 28 to emergency food pantries. The mobile market served 75 participants weekly and 15 individuals took part in cooking classes. Conclusions Screening for food insecurity and social isolation in the HMP helped to assess the prevalence of these social determinants of health in low-income older adults. Weekly congregate meals, home visits, and group cooking classes were initiatives taken to decrease the impact of food insecurity and social isolation in this vulnerable population.

This study proposes a model of household food spending that accounts for zero censoring and can be applied to data collected through a clustered survey design to investigate the impact of food sales taxes on three groups: households who are eligible for and participate in the Supplemental Nutrition Assistance Program (SNAP), households who are eligible but do not participate in the program, and households who are not eligible for the program. We find that SNAP participating households are largely insensitive to grocery taxes and respond to restaurant taxes by shifting more of their food dollars towards at‐home foods. Among households who are eligible for SNAP but do not participate in the program, grocery taxes reduce spending on foods purchased for at‐home consumption, and thereby increase the amount of the total food budget allocated to away from home foods. This is concerning from a nutrition and health standpoint since away from home foods tend to be more calorie dense and nutritionally poorer than at home foods.

This paper examines how benefits of the Supplemental Nutrition Assistance Program (SNAP) to low‐income households spillover between Portland, Oregon‐metropolitan core and its periphery trade area. The paper studies the impact of the SNAP program on four income classes by comparing the income increases generated by SNAP in 2006 in each income class in each region with a counterfactual scenario in which the taxes that would be needed from taxpayers in the region to support SNAP are treated as income and spent. The analysis shows that overall, SNAP payments net of taxes stimulate the regional economy and are significantly redistributive. Este articulo examina como se distribuyen los beneficios del Programa de Asistencia Nutricional Suplementaria (SNAP, por sus siglas en ingles) a los hogares de bajos ingresos entre el nucleo metropolitano de Portland (Oregon) y su area comercial periferica. El articulo estudia el impacto del programa SNAP sobre cuatro niveles de ingresos, mediante una comparacion de los aumentos de los ingresos generados por SNAP en 2006 en cada nivel de ingresos y para cada region con un escenario contrafactual, en el que los impuestos que se necesitarian de los contribuyentes de la region para apoyar SNAP se tratan como ingresos y gastos. En general, el analisis muestra que, los pagos de SNAP, netos de impuestos, estimulan la economia regional y son significativamente redistributivos. 本稿では、オレゴン州の大都市圏の中心であるポートランドと周辺の商業地域の間において、補助的栄養支援プログラム(Supplemental Nutrition Assistance Program:SNAP)の低所得世帯に対するベネフィットがどのように波及効果をもたらしているかを検討する。2006年にSNAPにより増加した各地域における各所得階層の所得と、SNAPを支えるために地域の納税者から必要とされる税金を所得として扱い費用として使うという事実に反するシナリオとを比較して、4つの所得階層に対するSNAPの影響を検討する。分析から、全体的に税控除後のSNAPの支払いは地域経済を刺激し再分配をもたらす効果が大きいことが示される。

The “right to food” has been formally implemented in some countries and, in other contexts, it is used as an exhortation for governments or other entities to take actions to reduce food insecurity. Central to any comprehensive set of policies to reduce food insecurity are food assistance programs directed towards vulnerable households. One example of such a food assistance program is in the United States, the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program). I begin by discussing one measure of a right to food, namely, to be free from food insecurity and then turn to a consideration the role of SNAP in meeting this goal. To do so, I cover five components that would seem to be essential to any definition of a right to food and how SNAP does and does not meet these components.

Leveraging a unique partnership with the North Texas Food Bank, we are able to collect original survey data from food pantry clients in North Texas to investigate a question that has received little attention due to a lack of data. Specifically, we assess the relationship between criminal incarceration and food security. Our analysis suggests minimal impact of incarceration, broadly defined, on household-level food security. However, differentiating between drug- and non-drug-related incarceration, our analysis suggests a positive causal effect of drug-related incarceration on food security, particularly among U.S. born households. This is consistent with an important role being played by the Supplemental Nutrition Assistance Program (SNAP) since many states ban participation by former drug offenders. To this end, we document a positive causal effect of incarceration on SNAP participation only among non-drug related offenders. The results call into question the efficacy of statutory bans on program participation for those reintegrating into society.

The objective of this paper is to develop a multiperiod, finite‐life, life cycle models of household decisions on food, leisure, and health (body mass index [BMI] or being obese) and to estimate econometric versions of these models treating SNAP (Supplemental Nutrition Assistance Program) participation as endogenous. A key insight from the economic models is that households allocate their wealth over the multiperiod life cycle to equalize the marginal utility of wealth in each period. The observations for this study are a balanced panel of over 1,600 women from the National Longitudinal Survey of Youth, 1979 Cohort (NLSY79). We focus on the 20‐year period starting in 1986, when SNAP data first became available. Women of all ages are included in the study because at the beginning of adulthood women cannot accurately predict over their life cycle labor and marriage market and health shocks that can thrust them into an economic position where they would qualify for SNAP. New findings include that a woman's household SNAP participation with or without updating for last periods health status and higher local dairy product prices reduce significantly her BMI and probability of being obese.

This article investigates the relationship between the timing of Supplemental Nutrition Assistance Program (SNAP) benefit payments and participation in school lunch and breakfast using the National Household Food Acquisition and Purchase Survey. An event study approach examines participation over the five‐day window before and after the SNAP payment. We find that school lunch participation decreases by 17–23 percentage points immediately after the SNAP payment among 11–18 year olds while breakfast drops by 19–36 percentage points. The decline begins the day prior to payment. We find no effects for 5–10 year olds. Models examining participation over the full SNAP month using individual fixed effects yield similar findings. Among teenagers, participation in school lunch and breakfast decline in the first two weeks of the SNAP month, increasing afterward. Non‐school meals show the opposite pattern. Overall, results indicate SNAP households rely more on school lunch and breakfast toward the end of the SNAP month.

Administrative data are considered the “gold standard” when measuring program participation, but little evidence exists on their potential problems or implications for econometric estimates. We explore these issues using the FoodAPS, a unique data set containing two different administrative measures of Supplemental Nutrition Assistance Program (SNAP) participation and a survey‐based measure. We document substantial ambiguity in the two administrative measures and show that they disagree with each other almost as often as they disagree with self‐reported participation. Estimated participation and misreporting rates can be meaningfully sensitive to choices made to resolve this ambiguity and disagreement. We explore sensitivity in regression estimates of the associations between SNAP and food insecurity, obesity, and the healthy eating index. The signs are unchanged across the three measures, and the estimates are mostly not statistically different from each other. However, there are some meaningful differences in the magnitudes and levels of statistical significance of the estimates.

There is an extensive research literature on the effects of the Supplemental Nutrition Assistance Program (SNAP) on food‐related outcomes which has shown somewhat mixed results but generally favorable effects. However, most of the research has used data sets whose information on SNAP participation is gathered from responses on household surveys, and such responses are subject to reporting error. This study uses the National Household Food Acquisition and Purchase Survey data set to examine the effect of reporting error on food‐related outcomes, for that data set contains information on SNAP participation gathered from government administrative records. Our analysis shows that the degree of reporting error is small and has little effect on the estimated impact of participation in the SNAP program on food security, diet quality, and food spending. A supplemental analysis of the effect of school food programs likewise shows no difference in using survey or administrative data in the analysis.

A central goal of the US Department of Agriculture is to reduce food insecurity among the US population. This is pursued both by agricultural policies that focus on food supply and, arguably of greater importance, through food and nutrition programmes. The Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program, is the largest in terms of the number of participants and annual expenditure. SNAP is particularly well‐suited to alleviating food insecurity insofar as it is designed to target those most in need, is flexible enough to address geographical variations in food insecurity, has the ability to expand in times of increased need, such as economic downturns, and gives recipients the dignity and autonomy to make their own food choices. Due to its size – about US$ 70 billion in expenditures per year – the programme has generated proposals to impose direct and indirect restrictions on recipients in order to reduce expenditure. These proposals include removing the ability of states to set higher income thresholds for eligibility, imposing work requirements, and curtailing the food choices of recipients. In contrast, other proposals would build on the perceived successes of SNAP both to expand the number of recipients and to increase benefit levels.

Evidence-based policies that effectively address adverse public health trends, including the increasing burden of diet-related disease and food insecurity, require quality and comprehensive data. For food and nutrition policy, that means data on household and individual food choices and the many factors influencing food demand, including income, food assistance program participation, food security status, and the local food environment. To meet this data need, the USDA sponsored the National Household Food Acquisition and Purchase Survey (FoodAPS), an innovative survey that collected nationally-representative data on household food purchases and acquisitions, including from low-income households and households participating in the Supplemental Nutrition Assistance Program (SNAP). To further enable and enrich analysis, the household survey data were linked to SNAP administrative records, USDA nutrient data, and geographic information related to the local food environment. This article provides a thorough overview of FoodAPS, including the rationale for the survey, recent research findings and insights on American diet quality, food assistance programs, and food environment, as well as the challenges encountered from developing, collecting, and processing the data.

RESEARCH OBJECTIVE: The Supplemental Nutrition Assistance Program (SNAP) has been found to reduce food hardships, which are associated with poor health and health care outcomes among children. Evidence that SNAP improves adult health and healthcare outcomes is growing, but studies including children have been limited. The need to assess these potential relationships among children with special health care needs (SHCN) is particularly pronounced, given their heightened social and health care complexity. We therefore aimed to (i) examine relationships between SNAP, food hardships, health status, and health care use among children, and (ii) examine whether SHCN status modified any of these relationships. STUDY DESIGN: To estimate the relationship between SNAP and food hardships, we followed prior studies in using a bivariate probit model with state‐level SNAP administrative policies as instruments (to account for disproportionate self‐selection into SNAP among households with high food hardships). We estimated this model within a structural equation modeling framework to simultaneously estimate downstream associations with health status and health care use. Household food insufficiency (FI) and excellent health status (versus very good, good, fair, or poor; a robust dichotomization among children) were modeled as mediators of the relationship between any SNAP receipt and any emergency department (ED) use over the prior year. We interacted SHCN status with SNAP to assess modification, and we adjusted for sociodemographic and environmental variables (e.g., exposure to smoking). Associations were estimated as the combination of direct and indirect effects. Predicted probabilities were calculated for interpretability. POPULATION STUDIED: Using pooled 2016, 2017, and 2018 National Survey of Children's Health data (nationally representative), we examined 17,791 children in households with income below 150% of the federal poverty level (a cutoff used in prior studies), 4710 of whom had SHCN based on a validated instrument. PRINCIPAL FINDINGS: SNAP was associated with: decreased FI likelihood, increased excellent health status likelihood, and decreased ED use likelihood; SHCN status was associated with an increase in the magnitude of each of these relationships. All associations had p‐values ≤0.001. See table: [Table: see text] CONCLUSIONS: SNAP was associated with significant beneficial effects regarding a child's likelihood of experiencing FI, excellent health status, and ED use, with even more beneficial effects found for children with SHCN. IMPLICATIONS FOR POLICY OR PRACTICE: Though an incomplete solution, SNAP may improve child health and healthcare outcomes, particularly for children with elevated vulnerabilities. Greater investments in food hardship relief by healthcare systems (e.g., SNAP enrollment assistance, food Rx programs) and policymakers (e.g., increased SNAP benefits, reduced enrollment barriers) may pay substantial dividends in improved outcomes for these populations and the health systems providing them care. PRIMARY FUNDING SOURCE: National Institutes of Health.

A well-known feature of the Supplemental Nutrition Assistance Program (SNAP) is that some recipients spend a disproportionate amount of their monthly benefit early in the month. Using a finite mixture model that optimally separates households into two groups, coupled with the National Household Food Acquisition and Purchase Survey, we re-examine this spending pattern. Results show that a minority of SNAP recipients cause the benefit cycle by spending, on average, two-thirds of their monthly benefit within the first four days. A potential implication of these findings is that more frequent SNAP benefit disbursal or educational programs designed to encourage smoother spending over the month might be of benefit to some SNAP households.

Objective The goal of this study was to understand the association between children's neighborhood food access and overweight/obesity in a national sample of US households, and whether this association differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. Methods Data were obtained from the National Household Food Acquisition and Purchase Survey (2012-2013; n = 3,748 children aged 2 to 18 years). Logistic regression was used to examine associations between neighborhood retail food access (≤1 mile from home), food purchases (including sugary beverages), and overweight/obesity, stratified by SNAP status (1,720 participants, 453 eligible nonparticipants, 1,575 SNAP ineligible). Store types included supermarkets/grocery, combination grocery/other (independent drug, dollar, and general stores), convenience, fast food, and non-fast food restaurants. Results Odds of childhood overweight/obesity (OR [95% CI]) were higher with greater access to combination grocery/other stores overall (1.10 [1.03-1.17]) and for children in SNAP (1.14 [1.05-1.24]). Eligible non-SNAP children had higher odds of overweight/obesity with greater access to convenience stores (1.11 [1.04-1.18]). The average child lived in a household with 6.3% of total spending at food outlets on sugary beverages (SNAP: 8.3%, eligible non-SNAP: 7.7%, SNAP ineligible: 5.5%). Conclusions Greater neighborhood access to combination grocery/other stores is associated with higher obesity prevalence for children overall and those in SNAP.

Promoting use of farmers' markets (FMs) is a promising community-level strategy to increase access to nutritious foods such as fruits and vegetables. Yet, FM shopping among people with Supplemental Nutrition Assistance Program (SNAP) benefits remains low. This research examined predictors of FM shopping among SNAP recipients living within 1 mile of a FM. A cross-sectional survey of SNAP participants (N = 270) was conducted in 2015 in Cleveland and East Cleveland, OH, USA. Multinomial regression and zero-truncated Poisson regression analyses were conducted to examine factors associated with FM shopping. Results indicate 48% reported shopping at a FM at least once in the past year, 26% had shopped at a FM before, but not in the last year, and 26% had never shopped at a FM. The multivariable analyses found awareness of FMs and a healthy food incentive program, and four dimensions of healthy food access are significantly associated with FM shopping among SNAP recipients. The food access dimensions included service delivery, spatial-temporal, personal, and social access. Findings highlight modifiable leverage points for improving the reach of FMs among low-income populations.

OBJECTIVE This study aimed to examine the feasibility and initial efficacy of a novel default option intervention targeting nutritional quality of online grocery purchases within the financial constraints of food insecurity. METHODS Female undergraduates (n = 59) without eating disorder symptoms or dietary restrictions selected foods online with a budget corresponding to maximum Supplemental Nutrition Assistance Program benefits. Before completing the task again, participants were randomly assigned to receive a $10 incentive for selecting nutritious groceries (n = 17), education about nutrition (n = 24), or a default online shopping cart containing a nutritionally balanced selection of groceries (n = 18) to which they could make changes. Nutritional quality was quantified by using the Thrifty Food Plan Calculator. RESULTS Compared with the education condition, participants in the default condition selected significantly more whole grains and fruits and foods lower in cholesterol, saturated fats, sodium, and overall calories. There were no statistically significant differences in nutritional outcomes between the incentive condition and the other two groups. CONCLUSIONS Findings provide initial support for the efficacy of a default option in facilitating healthier food choice behaviors within financial constraints.

The adequacy of the Supplemental Nutrition Assistance Program (SNAP) benefits is always an important concern. This article extends the most common measure for evaluating the adequacy of SNAP, food expenditures, and uses more comprehensive metrics to evaluate the impact of the American Recovery and Reinvestment Act (ARRA). These more comprehensive metrics are easy to implement with existing data, more closely tied to the purpose of the SNAP, and indicate a slightly larger impact of the ARRA.

Food insecurity is now recognized as a major health crisis in the United States. This is due to the size of the problem—more than 42 million persons were food insecure in 2015—as well as the multiple negative health outcomes and higher health care costs attributable to food insecurity. An extensive body of literature from multiple fields has examined the causes and consequences of food insecurity and the efficacy of food assistance programs—especially the Supplemental Nutrition Assistance Program. We review this literature and provide suggestions for future research directions. We suggest examining the distribution of food insecurity within households, the impact of the food distribution system on food insecurity, the coping mechanisms of low-income food secure families, food insecurity among American Indians, the effects of charitable food assistance, the causal relationship between food insecurity and health outcomes, the declining age gradient in food insecurity among Seniors, the effects of labor force participation and the Great Recession on food insecurity, and the long-term consequences of food insecurity. In addition, the impact of two recent policy recommendations on food insecurity – the minimum wage and the Affordable Care – Act should be considered.

Objectives It is unknown if the explosion in Supplemental Nutrition Assistance Program (SNAP) usage during the Great Recession was due to an inflow of new participants or instead because former participants cycled back into the program. It is also unknown if the profiles of new and return participants differed on a set of core demographic characteristics, including race/ethnicity, gender, education, age, household configuration, and location. Methods I examine the complete adult SNAP participation histories for a nationally representative cross-section of 7,680 individuals at the end of the Great Recession. Data are from the Panel Study of Income Dynamics with observations spanning the period 1968–2010. Results A large number of adult SNAP participants used the program for the first time during the Great Recession. New participants were not solely young adults and often originated from groups not typically associated with social program participation, such as: whites, suburbanites, and the highly educated. Repeat participants had varying program histories prior to the recession. Some spent a substantial portion of adulthood receiving program benefits while most others were only sporadic participants. Conclusions The findings demonstrate that SNAP was very successful in reaching the many new types of people who were exposed to the risk of poverty as a result of the economic downturn.

Effects of the 2013 Supplemental Nutrition Assistance Program (SNAP) benefit cut on food security is examined by employing the annual Current Population Survey Food Security Supplement 2012–2014. Food security measured in December 2014 is compared with the corresponding statistics for December 2012 using difference-in-differences methods. Results confirm that reduced SNAP benefits significantly threatened the food security of SNAP households.

This article examines whether expanding Supplemental Nutrition Assistance Program (SNAP) eligibility reduces material hardships of low-income households. During the Great Recession, many states expanded the income threshold of eligibility for SNAP. I show that expansions in eligibility increased the SNAP participation rate by 3–5 percentage points. I also find that the expansion leads to a modest decrease in nonfood hardships, such as rent and utility delinquencies. However, the increase in SNAP enrollment does not lead to greater food spending or a reduction in food insecurity except for households with children.

Poverty is a major social problem in the United States: in 2014, the U.S. Census Bureau reported 46.7 million people living in poverty and an estimated 14.8 percent poverty rate. The poverty rate has been steadily increasing in the United States, with a 2 percent increase in 2012 over 2007. Federal and state governments have initiated many anti-poverty programs, starting with the New Deal Program in the 1930s. With the advent of a new governance approach in the 1990s, many hierarchical bureaucratic government agencies were replaced with public, private, network, and collaborative approaches to solve this complex national problem. Tax expenditures, vouchers, and grants are the three major governance tools used by the U.S. federal and state governments to fight poverty. This article addresses three important programs—the Earned Income Tax Credit (EITC), the Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance for Needy Families (TANF)—used in fighting poverty in the United States and discusses the problem of poverty, the effectiveness of these governance tools, suggestions for future research, and policy implications

The Supplemental Nutrition Assistance Program (SNAP) is the largest nutritional safety net in the United States. Prior research has found that participants have higher consumption shortly after receiving their benefits, followed by lower consumption towards the end of the benefit month. Known as the “SNAP benefit cycle,” this consumption pattern has been found to have negative effects on beneficiaries. We hypothesize two behavioral responses of SNAP participants may work in tandem to drive much of the cycle: (1) short-run impatience—a higher preference to consume today, and (2) fungibility of income—the degree of substitutability between a SNAP dollar and a cash dollar. Using data from the National Food Acquisition and Purchase Survey (FoodAPS), a newly developed nationally representative survey of daily food acquisitions by SNAP households, we find evidence of both behavioral responses. However, the degree of short-run impatience and fungibility of income is found to differ significantly across poverty levels and use of grocery lists to plan food purchases. SNAP households could gain from food purchase planning education.

The longitudinal Three City Study (TCS) of low-income families with children measures food hardships using fewer and some different questions from the standard U.S. instrument, the Household Food Security Survey Module (HFSSM) in the Current Population Survey (CPS). We use a Rasch measurement model to identify thresholds of very low food security among households and among children in the TCS that are comparable to thresholds from the HFSSM. We also use the TCS to empirically investigate the determinants of food insecurity and of these specific food insecurity outcomes, estimating a multivariate behavioral Rasch model that is adapted to address longitudinal data. The estimation results indicate that participation in the Supplemental Nutrition Assistance Program and the Temporary Assistance for Needy Families program reduce food insecurity, while poverty and disability among caregivers increase it. Besides its longitudinal structure, the TCS measures many more characteristics about households than the CPS. Our estimates reveal that financial assistance through social networks and a household's own financial assets reduce food insecurity, while its outstanding loans increase insecurity.

This article reports spending results for the USDA's Healthy Incentives Pilot (HIP), which tested a 30% incentive on fruit and vegetable purchases with Supplemental Nutrition Assistance Program (SNAP) benefits. Self-reported mean usual monthly spending for all fruits and vegetables was $6.15 higher for randomly assigned HIP participant households than for a control group. Much of the additional spending appears to have taken place in ways that did not earn the incentive—spending with non-SNAP resources or in retailers that did not participate in HIP. This article investigates mechanisms that might explain the HIP impact on fruit and vegetable purchases that did not earn the incentive.

The Supplemental Nutrition Assistance Program (SNAP) has grown rapidly in recent years—by about 50% in the seven years between 2000 and 2007, and by another 70% in the four years between 2007 and 2011—such that in 2011, SNAP served 14% of the U.S. population. Contributing to our understanding of the causes of this very rapid increase in the caseload, this article extends the time period of analysis through and past the official end of the Great Recession, analyzes more geographically disaggregated caseloads and the impact of substate economic conditions, and considers the impact of recent major, state-level SNAP policy changes. In models that exploit substate-level data, we find consistent evidence of significant impacts of both the substate level and statewide economy on local area SNAP caseloads. Surprisingly, while one might have expected more geographically disaggregated data to improve the alignment of the measurement with the concept of interest (i.e., the labor market opportunities of an individual), and therefore lead to larger estimates of the impact of the economy, in fact estimates fall—perhaps due to measurement error. We find at best mixed evidence of policy impacts. Simulations indicate that the economy can account for most of the 2007 to 2011 increase in the caseload, although relatively less of the 2000 to 2007 increase. Nonetheless, the role of the economy in driving caseloads appears to be substantial in both periods.

Residents of neighborhoods with limited access to grocery stores may face barriers to obtaining adequate food for a healthy diet. Low‐income elderly may be uniquely affected by these so‐called “food deserts” due to limited transportation options, strong attachments to local neighborhoods, fixed incomes, and physical limitations for food shopping. Using 2006 and 2010 Health and Retirement Study data linked to census tract‐level measures of food deserts, this study measures whether living in a food desert affects food and material hardship, participation in food assistance programs, and the food spending of elderly adults. In both cross‐sectional and fixed effects regressions of elderly residents of urban counties, we find little evidence that living in a food desert affects these outcomes. We find, however, that individuals residing in a food desert without a vehicle are 12 percentage points more likely to report food insufficiency. Those SNAP recipients living in food deserts are 11 percentage points more likely to receive subsidized meals, while nonparticipants in food deserts and SNAP recipients outside of food deserts are less likely to receive subsidized meals. Our findings suggest that seniors without vehicles and SNAP recipients in food deserts may be the most vulnerable to limited food store access.

Objective This study examines changes in household food expenditures in the months directly around entry into the Supplemental Nutrition Assistance Program (SNAP). Methods Using monthly data on SNAP participation from the Panel Study of Income Dynamics (PSID), we estimate food-expenditures-to-food-needs ratio with an event-study specification. Results Upon entering the program, a substantially lower share of out-of-pocket spending accounts for SNAP households’ food budgets. However, these expenditures are largely replaced with SNAP benefits, resulting in little changes in total food expenditures. We also identify the co-occurrence of household economic shocks at the point of SNAP entry. Conclusion SNAP entry is preceded by reduced rates of employment and marriage among heads of households, suggesting that household economic shocks may trigger SNAP entry. We find that SNAP benefits visibly appear to act as an important safety net for households who have recently entered the program, cushioning them from the extent of a negative shock in food expenditures that they might otherwise have faced.

Objective The objective of this study was to examine the relationship between the nutritional status, incidence of food insecurity, and health risk among the homeless population in Rhode Island. Design and Sample This correlational study utilized a convenience sample of 319 homeless adults from Rhode Island's largest service agency for the homeless. Information on use of services such as access to emergency foods, shelters, and the Supplemental Nutrition Assistance Program (SNAP) was requested. Measures Food security was measured by the six-item subset of the USDA Food Security Core Module. Anthropometric measures included height, weight, and waist circumference. A 24-hr dietary recall was collected to determine the food intake for a subset of participants who agreed to supply this information (n = 197). Conclusion Average dietary recall data indicated insufficient intake of vegetables, fruit, dairy, and meats/beans. It also indicated excessive intake of fats. Of the 313 participants, 29.4% were overweight and 39% were obese. Over 94% of the participants were food insecure, with 64% of this subset experiencing hunger. Fifty-five percent of the participants were currently receiving SNAP benefits. The majority of the sample was found to be food insecure with hunger.

Fruit and vegetable consumption of Native Americans was compared with that of non-Native Americans and determinants of fruit and vegetable intake for both populations were found based upon the Theory of Planned Behavior. A one-time survey was conducted as part of a larger research project funded by the South Dakota Department of Health. The survey was administered in local grocery stores and supermarkets in six South Dakota communities, including two located on Native American reservations. Of the 1000 distributed surveys, 499 were returned with 230 being usable, resulting in a response rate of 49.9%. Wilcoxon signed-rank test and two regression models were tested using SAS 9.2 software. Dependent variables were fruit and vegetable intake. Attitudes towards health, fruit and vegetable consumption, perceived difficulty, subjective norm and intention were also measured. Community size, family income, employment status and participation in food assistance programmes [Supplemental Nutrition Assistance Program or Women, Infants, and Children (SNAP or WIC)] were socio-demographic control variables. Overall, Native American participants consumed more fruit and vegetables at home and had a more positive attitude towards healthy diets than non-Native American participants. SNAP or WIC participation, family health, exercise, intention to live healthier than parents, buying healthy food, and fruit and vegetable consumption when eating out were positively associated with fruit and vegetable consumption among Native Americans, while participation in the SNAP or WIC programme had a negative influence on consumption among non-Native American participants. Family health, exercise, buying healthy food, fruit and vegetable when eating out, and intention to buy healthy food were positively associated with fruit and vegetable consumption among the non-Native American population. Theory of Planned Behavior variables (e.g. attitude towards healthy food) significantly contributed to the model explaining fruit and vegetable consumption. The fact that SNAP and WIC participation had an opposite influence on the two populations warrants further research.

The monthly cycle of daily food intake among adult participants in the Supplemental Nutrition Assistance Program is examined using data from the 2007–10 National Health and Nutrition Examination Survey. Exogenous variation in interview and benefit receipt dates provides means for identification, and a difference-in-differences specification is used to account for the large boost in benefits that began in April 2009 via the American Recovery and Reinvestment Act (ARRA). Caloric intake declined as much as 25% at the end of the month prior to ARRA, but not after implementation. Few differences were observed for diet quality measures or among subgroups. Increases in SNAP benefit amounts may help smooth food intake over the benefit month.

Recent studies on food stamp participant households’ marginal propensity to spend out of food stamps versus income have had contradictory results: experimental studies have found household behavior aligns with standard economic theory where households’ marginal propensity to spend on food out of food stamps is equivalent to cash income; observational studies nd that households have a larger marginal propensity to spend out of food stamps than cash income. In this study, we re{examine this question by estimating how an unprecedentedly large increase in food stamp benets due to the implementation of the American Recovery and Reinvestment Act aects food{at{home expenditure. We nd that the policy change caused households to increase food{at{home expenditure as well as increase households’ share of total expenditure allocated toward food{at{home expenditure. We compare these results to a time period without a meaningful food stamp policy change and nd our results are unique to the ARRA implementation time period.

In response to low consumption levels of fruits and vegetables by Supplemental Nutrition Assistance Program (SNAP) participants, the USDA Food and Nutrition Service created the Healthy Incentives Pilot (HIP) to test the efficacy of providing a 30% incentive for purchases of targeted fruits and vegetables (TFVs). Four to six months after implementation, mean daily TFV intake for adult HIP participants was 0.22 cup-equivalents higher (24% higher) than for control-group SNAP participants. These impact estimates with a random-assignment research design generally agree with previously published nonexperimental elasticity estimates, which imply that a pure price reduction of 30% would increase fruit and vegetable consumption by about 20%.

We examine enrollment in the U.S. Medicaid and Supplemental Nutrition Assistance Programs (SNAP) by health status and find that while SNAP-eligible adults in poor overall health and with multiple chronic conditions are more likely to jointly enroll in SNAP and Medicaid, they are less likely to enroll in SNAP alone. We also find that the conditional probability of SNAP enrollment given Medicaid participation is higher for individuals with multiple chronic conditions, indicating that the Medicaid program facilitates food assistance receipt for these individuals. As a result, both Medicaid expansions and state and federal policies that harmonize eligibility criteria or promote enrollment coordination between SNAP and Medicaid are expected to increase the number of individuals in SNAP with chronic medical conditions. Such a change in the composition of SNAP enrollees would increase the justification for using SNAP as a platform for health promotion initiatives.

Objectives As obesity rates remain alarmingly high, the importance of healthful diets is emphasized; however, affordability of such diets is disputed. Market basket surveys (MBSs) investigate the affordability of diets for families that meet minimum daily dietary requirements using actual food prices from grocery stores. This review paper describes the methods of MBSs, summarizes methodology, price and affordability findings, limitations, and suggests related policy and practice implications. Design and Sample This is a systematic review of 16 MBSs performed in the United States from 1985 to 2012. A comprehensive multidisciplinary database search strategy was used to identify articles meeting inclusion criteria. Results Results indicated MBS methodology varied across studies and price data indicated healthful diets for families are likely unaffordable when purchased from small- to medium-sized stores and may be unaffordable in larger stores when compared to the Thrifty Food Plan. Conclusions Using a social ecological approach, public health nurses and all public health professionals are prime advocates for increased affordability of healthful foods. This study includes policy advocacy, particularly in support of Supplemental Nutrition Assistance Program benefits for low-income families. Future research implications are provided, including methodological recommendations for consistency and quality of forthcoming MBS research.

Whether government-based forms of food assistance such as the Supplemental Nutrition Assistance Program (SNAP), communal efforts including food pantries, aid from friends and family, or alternative means such as gardening are the appropriate means to reduce the prevalence of household food insecurity is a continuous source of policy contention. To inform this debate, we examine the relative importance of these forms of food assistance and acquisition to a sample of U.S. older adults from the 2010 Brazos Valley Health Assessment of central Texas households that have been stratified by income eligibility for SNAP, low-income SNAP ineligibility, and above low income status. To identify how membership in these socioeco- nomic groups constrains household capacity to acquire sufficient food to maintain an adequate and healthy diet, we explore the varied associations of assets received from government; communal and intimate social networks; and alternative food sources such as gardening, hunting, and fishing with household food security across socioeconomic status, while examining the importance of place of residence on the use of capital assets. SNAP partici- pation was the only specific capital asset associated with all levels of food insecurity for both SNAP-eligible and ineligible low-income groups, thus emphasizing the continued importance of food assistance among poverty- level older adults.

Context American obesity rates continue to escalate, but an effective policy response remains elusive. Specific changes to the Supplemental Nutrition Assistance Program (SNAP) have been proposed as one way to improve nutrition and combat obesity among lower-income populations. While current SNAP proposals hold promise, some important challenges still remain.

SummaryWhat is already known about this subject Most prior work suggests no consistent association between food assistance programme participation and increased risk for youth overweight. Previous studies have not accounted for youth food insecurity status, which may modify this relationship. What this study adds Associations between food assistance programme participation and youth overweight are modified by food insecurity. In a national sample, food-secure youth, but not food-insecure youth, participating in food assistance programmes had increased body size both by body mass index and waist circumference measures. Objective To investigate food assistance participation as a risk factor for overweight and obesity in youth, and food insecurity as an effect modifier. Methods The sample included youth ages 4–17, in families ≤200% of the federal poverty line in the 2007–2008 National Health and Nutrition Examination Survey (n = 1321). Food insecurity was measured with the US Department of Agriculture survey module. Food assistance participation was assessed for Supplemental Nutrition Assistance Program, Special Supplemental Nutrition Program for Women, Infants and Children and school meals. Body size was classified by age- and sex-specific body mass index (BMI) percentile, BMI z-score and waist circumference percentile. Regression models with direct covariate adjustment and programme-specific propensity scores, stratified by food insecurity, estimated associations between food assistance participation and body size. Results Food assistance participation was not associated with increased body size among food-insecure youth in models with direct covariate adjustment or propensity scores. Compared with low-income, food-secure youth not participating in food assistance, BMI z-scores were higher among participants in models with direct covariate adjustment (0.27–0.38 SD and 0.41–0.47 SD, for boys and girls, respectively). Using propensity scores, results were similar for boys, but less so for girls. Conclusions Food assistance programme participation is associated with increased body size in food-secure youth, but not food-insecure youth. Using both direct covariate adjustment and a propensity score approach, self-selection bias may explain some, but not all, of the associations. Providing healthy food assistance that improves diet quality without contributing to excessive intake remains an important public health goal.

Social media has a potential to deliver nutrition education messages effectively and efficiently to large, underserved populations, but little is known about the current social media usage pattern ...

ObjectiveTo determine the relationship of rural and urban county household status to long-term food security among households with children in Indiana after a Supplemental Nutrition Assistance Prog...

SNAP-Ed provides nutrition education to low-income Americans to help them make healthy choices within a limited budget. The purpose of this study was to examine the impact of SNAP-Ed participation ...

BACKGROUND: An increased prevalence of overweight and obesity for adults on government-funded nutrition assistance, such as the Supplemental Nutrition Assistance Program (SNAP), has been observed; however, this association among preschool-aged children is not well understood. Longitudinal research designs tracking changes in body mass index-for-age (BMI) in children of low-income households may provide a clearer picture of the association between SNAP participation and overweight and obesity among this age group. To determine if there is a relationship between SNAP participation and overweight and obesity prevalence in low-income, preschool children, we conducted a cross-sectional analysis of children in a Head Start program, and a longitudinal analysis of those children who were enrolled for 2 years. METHODS: Height and weight data and SNAP participation of 386 students (207 male, 179 female, 4.2 ± 0.5 years) enrolled in a Head Start program were analyzed; data for 2 years were available for 167 of the students. Height and weight measures were used to determine BMI percentile per Centers for Disease Control and Prevention guidelines. SNAP participation was obtained through a nutritional questionnaire given to parents at time of Head Start Program enrollment. RESULTS: No significant differences were found between SNAP and non-SNAP participants for BMI percentile in either the cross-sectional or longitudinal analysis. BMI percentile increased for both groups over time, but failed to reach significance (p = .13). CONCLUSION: Future studies are warranted with an inclusion of a larger and more geographically diverse sample to further determine the association between SNAP participation and overweight and obesity in preschool-aged children.

Food insecurity is experienced by millions of Americans and has increased dramatically in recent years. Due to its prevalence and many demonstrated negative health consequences, food insecurity is one of the most important nutrition-related public health issues in the U.S. In this article, we address three questions where economic insights and models have made important contributions: What are the determinants of food insecurity?; What are the causal effects of food insecurity on health outcomes?; and What is the impact of food assistance programs on food insecurity? We conclude with a discussion of the policy implications of the answers to these questions and future research opportunities in this research venue. Copyright 2011, Oxford University Press.

Between 2000 and 2005, the Supplemental Nutrition Assistance Program (SNAP, until recently, the Food Stamp Program) caseload increased by half. As the Great Recession unfolded, the SNAP caseload grew even more rapidly. Further, over the past two decades the composition of the caseload has shifted sharply away from families combining food and cash assistance and toward families receiving food assistance in the absence of any other major, means-tested income support. By analyzing components of the caseload separately, we provide new and more insightful estimates of the effects of food and cash assistance policies and the economy on both the change in the composition of the caseload and the large caseload swings over the 1990s and 2000s. We find that the economy can explain a portion of caseload changes, but not compositional shifts. Food and cash assistance policies help to explain both changes. In total, the combination of SNAP and welfare policy changes account for about half of the sharp increase since 1994 in the share of SNAP households receiving food, but not cash, assistance. © 2011 by the Association for Public Policy Analysis and Management.